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Humeral shaft fracture

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https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#1
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697085/humeral-shaft-fracture-intramedullary-nailing
#2
Sanjit R Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture. METHODS: The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure. RESULTS: This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28694341/open-reduction-and-internal-fixation-of-humeral-shaft-fractures-versus-conservative-treatment-with-a-functional-brace-a-study-protocol-of-a-randomised-controlled-trial-embedded-in-a-cohort
#3
Lasse Rämö, Simo Taimela, Vesa Lepola, Antti Malmivaara, Tuomas Lähdeoja, Mika Paavola
INTRODUCTION: Humeral shaft fractures represent 1%-3% of all fractures and 20% of humeral fractures in adults. The treatment of these fractures is mainly conservative and operative treatment is usually reserved for specific circumstances. To date, no randomised controlled trial (RCT) has compared operative treatment of humeral shaft fractures with conservative treatment. METHODS AND ANALYSIS: We will conduct an RCT to compare the effectiveness and cost-effectiveness of surgical and conservative treatment of humeral shaft fractures...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667397/delayed-union-of-humeral-shaft-fractures-comparison-of-autograft-with-and-without-platelet-rich-plasma-treatment-a-randomized-single-blinded-clinical-trial
#4
Carlos Acosta-Olivo, Abiel Garza-Borjon, Mario Simental-Mendia, Felix Vilchez-Cavazos, Yadira Tamez-Mata, Victor Peña-Martinez
INTRODUCTION: Despite an adequate orthopedic treatment with functional bracing, some patients develop a delayed union in humeral shaft fractures. The objective of the present study was to determine the bone consolidation time among patients with delayed union of diaphyseal humeral fractures who were managed with locking compression plate (LCP) fixation combined with an iliac crest autograft using platelet-rich plasma (PRP) as a co-adjuvant. MATERIALS AND METHODS: This study was a controlled, randomized, experimental, longitudinal, comparative, prospective, blind clinical trial...
June 30, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28659054/self-reducing-proximal-humerus-fractures
#5
Christopher Fang, Ernest Beng Kee Kwek
BACKGROUND: Proximal humeral fractures are common in the elderly and can present with multiple fracture configurations. Our case series describes a three-part valgus-impacted fracture pattern of the proximal humerus that underwent spontaneous reduction by nonsurgical management with good functional outcomes. METHODS: Seven patients who sustained low-energy three-part valgus-impacted fractures of the proximal humerus were studied. We retrospectively reviewed serial anteroposterior radiographs of each patient taken as part of routine follow-up...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#6
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28560796/postoperative-evaluation-of-reduction-loss-in-proximal-humeral-fractures-a-comparison-of-plain-radiographs-and-computed-tomography
#7
Xiao-Yang Jia, Yan-Xi Chen, Min-Fei Qiang, Kun Zhang, Hao-Bo Li, Yu-Chen Jiang, Yi-Jie Zhang
OBJECTIVE: To compare postoperative CT images with plain radiographs for measuring prognostic factors of reduction loss of fractures of the proximal part of the humerus. METHODS: A total of 65 patients who sustained fractures of the proximal humerus treated with locking plates from June 2012 to October 2015 were retrospectively analyzed. There were 24 men and 41 women, with a mean age of 60.0 years (range, 22-76 years). According to the Neer classification system of proximal humeral fracture, there were 26 two-part, 27 three-part and 12 four-part fractures of the proximal part of the humerus, and all fractures were treated with open reduction and internal fixation (ORIF) using locked plating...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28540999/do-cerclage-cables-delay-the-time-to-bone-union-in-patients-with-an-unstable-humeral-shaft-fracture-treated-with-intramedullary-nails
#8
Kyeong Jin Han, Doo Hyung Lee, Joon Young Bang
PURPOSE: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures. MATERIALS AND METHODS: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64)...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#9
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499398/biomechanical-evaluation-of-a-novel-dualplate-fixation-method-for-proximal-humeral-fractures-without-medial-support
#10
Yu He, Yaoshen Zhang, Yan Wang, Dongsheng Zhou, Fu Wang
BACKGROUND: Comminuted fractures of the proximal humerus are generally treated with the locking plate system, and clinical results are satisfactory. However, unstable support of the medial column results in varus malunion and screw perforation. We designed a novel medial anatomical locking plate (MLP) to directly support the medial column. Theoretically, the combined application of locking plate and MLP (LPMP) would directly provide strong dual-column stability. We hypothesized that the LPMP could provide greater construct stability than the locking plate alone (LP), locking plate combined with a fibular graft (LPSG), and locking plate combined with a distal radius plate (LPDP)...
May 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28486287/controlled-compression-nailing-for-at-risk-humeral-shaft-fractures
#11
J Tracy Watson, Roy W Sanders
Compression techniques seem to be the primary factor in determining the success of both plating and nailing techniques for the management of acute fractures and for delayed and nonunion management of these fractures. An intramedullary nail that can provide continual compression (like a plate) and mechanical manipulation of the callous throughout the course of treatment is an ideal device that provides all the advantages of plating and nailing and avoids the noted limitations of both. The UNYTE compression humeral nail is based on the PRECICE intramedullary limb lengthening system...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28484909/humeral-shaft-fractures-national-trends-in-management
#12
Bradley S Schoch, Eric M Padegimas, Mitchell Maltenfort, James Krieg, Surena Namdari
BACKGROUND: The incidence of humeral shaft fractures has been increasing over time. This represents a growing public health concern in a climate of cost containment. The purpose of this study is to analyze national trends in surgical management of humeral shaft fractures and determine factors predictive of surgical intervention. MATERIALS AND METHODS: Humeral shaft fractures were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes 812...
May 8, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28461960/radial-nerve-palsy
#13
Marko Bumbasirevic, Tomislav Palibrk, Aleksandar Lesic, Henry DE Atkinson
As a result of its proximity to the humeral shaft, as well as its long and tortuous course, the radial nerve is the most frequently injured major nerve in the upper limb, with its close proximity to the bone making it vulnerable when fractures occur.Injury is most frequently sustained during humeral fracture and gunshot injuries, but iatrogenic injuries are not unusual following surgical treatment of various other pathologies.Treatment is usually non-operative, but surgery is sometimes necessary, using a variety of often imaginative procedures...
August 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28417290/unilateral-external-fixator-in-the-treatment-of-humeral-shaft-fractures-results-of-a-single-center-retrospective-study
#14
M Basso, M Formica, L Cavagnaro, M Federici, M Lombardi, F Lanza, L Felli
BACKGROUND: The aim of our work is to evaluate and critically analyze long-term clinical and radiological data of a new unilateral external fixator (MIKAI KIT FEP©-Mikai S.p.A, Genoa, Italy), in the treatment of humeral shaft fractures. MATERIALS AND METHODS: We reviewed 47 patients affected by humeral fractures that underwent surgery from July 2010 to March 2016 with unilateral external fixator. Demographic characteristics of the patients were recorded, which included age, sex and baseline comorbidities and mechanism of injury...
April 17, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#15
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
May 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28375900/an-excellent-study-of-operative-versus-nonoperative-treatment-of-humeral-shaft-fractures-commentary-on-an-article-by-fabio-teruo-matsunaga-md-phd-et-al-minimally-invasive-osteosynthesis-with-a-bridge-plate-versus-a-functional-brace-for-humeral-shaft-fractures
#16
https://www.readbyqxmd.com/read/28375891/minimally-invasive-osteosynthesis-with-a-bridge-plate-versus-a-functional-brace-for-humeral-shaft-fractures-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Fabio Teruo Matsunaga, Marcel Jun Sugawara Tamaoki, Marcelo Hide Matsumoto, Nicola Archetti Netto, Flavio Faloppa, Joao Carlos Belloti
BACKGROUND: Nonoperative treatment has historically been considered the standard for fractures of the shaft of the humerus. Minimally invasive bridge-plate osteosynthesis for isolated humeral shaft fractures has been proven to be a safe technique, with good and reproducible results. This study was designed to compare clinical and radiographic outcomes between patients who had been treated with bridge plate osteosynthesis and those who had been managed nonoperatively with a functional brace...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28370473/-half-folded-pedicled-scapular-bone-flap-for-nonunion-after-humeral-neck-fracture-a-case-report
#18
Gen Matsumae, Makoto Motomiya, Naoya Watanabe, Norimasa Iwasaki
Treatment of a nonunion of the proximal humerus remains a challenge because of the small proximal fragment and poor central cancellous bone stock of the humeral head. In this report, we describe our experience using a "half-folded" pedicled scapular bone flap with an anatomical locking plate to treat an atrophic nonunion of the proximal humerus in a 64-year-old right-handed woman. The patient had fallen and experienced a common humeral neck fracture 2.5 years previously. During the operation, we elevated the pedicled scapular bone flap, which measured 8...
March 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28359639/lateral-para-olecranon-approach-for-the-treatment-of-distal-humeral-fracture
#19
Takuji Iwamoto, Taku Suzuki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato
PURPOSE: To assess the outcomes of the lateral para-olecranon triceps-splitting approach for the treatment of distal humeral fracture. METHODS: Ten patients (3 males, 7 females) with a mean age of 59 years were retrospectively reviewed. There were 2 A2, 3 C1, and 5 C2 fractures according to the AO/ASIF classification. Types B3 and C3 fractures were excluded from this study because the olecranon osteotomy approach was indicated to visualize the anterior fragment...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28333947/surgical-interventions-to-treat-humerus-shaft-fractures-a-network-meta-analysis-of-randomized-controlled-trials
#20
Jia-Guo Zhao, Jia Wang, Xiao-Hui Meng, Xian-Tie Zeng, Shi-Lian Kan
BACKGROUND: There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. METHODS: MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016...
2017: PloS One
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